With maternal morbidity and mortality continuing to be a major challenge – especially in certain regions and among Black mothers1 – states must consider more ways to ensure pregnant people get the support they need for better health outcomes. One support type shown to improve maternal and infant health outcomes is trained, professional doula care.
Doula care can also decrease costs and reduce health disparities for BIPOC communities. It results in 28% fewer cesareans, 34% fewer negative birth experiences and a 9% drop in pain medication use.
This whitepaper discusses opportunities to make a positive impact on health through the expansion of Medicaid benefits to cover doula care for mothers and babies. Four states are already providing Medicaid benefits for doula care and six recently authorized coverage and are moving toward implementation. More than a dozen other states considered legislation during the 2021 legislative sessions to make doula care a Medicaid-covered benefit.
Keys to program design success for this vital Medicaid program are:
- Ensuring that doula care is classified as a preventive service
- Allowing doulas to provide a full range of non-clinical support
- Serving all pregnant individuals across broad populations
- Establishing doula certification, training and enrollment requirements
- Creating an adequate reimbursement structure
